A "provocative" print and television advertising campaign promoting hepatitis B vaccinations was launched this week in San Francisco, where as many as one in 10 members of the city's Asian communities are infected with the virus, the New York Times reports. In the general population, about one in 1,000 people are infected with hepatitis B, which attacks the liver and can be spread through blood and other bodily fluids. Edward Chow, vice president of the city's Health Commission, said people with hepatitis B disease often display few symptoms. About 25% of patients develop serious ailments, such as liver failure, if left untreated.

The campaign was created by San Francisco Hep B Free, a group that hopes to eradicate the disease through citywide vaccination. One ad shows 10 beauty contestants, with the question, "Which one deserves to die?" The other ads include the same question with photos of Asian community members who volunteered to pose as families, a basketball team, office workers and doctors. The ads urge people to get a "simple blood test" and note that the disease "can be treated, even prevented." The campaign is published in several languages -- including Chinese, Korean and Vietnamese -- and also will target English-speaking doctors who might not be aware of the disease's prevalence in the Asian community.

The campaign is already attracting controversy, the Times reports. Vicky Wong -- president and CEO of DAE, the firm that developed the ads -- said some volunteers for the ads left the photo session because they were concerned about the campaign's approach. Wong said, "There were so many debates as to whether" the campaign went too far, but "there's a lot of people who loved it." According to the Times, a "more gentle" Hep B Free campaign several years ago used the tagline "B A Hero," which organizers said was not a strong enough message. Wong said, "Saying 'Life is beautiful; get tested,' doesn't work."

According to Chinese-American community leaders, there is a stigma in Asian communities surrounding hepatitis B, which is endemic in much of Asia. Ted Fang, a committee member with Hep B Free, said the high rate of infection among Asians is particularly frustrating because the hepatitis B vaccine has existed for nearly three decades. He said, "We have the medical tools, so long as doctors will test their patients and monitor them," adding, "We can knock out this disease" (McKinley, New York Times, 5/2).

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